Provider Demographics
NPI:1730816836
Name:TIFFANY WHITE PARKER, DDS, P.A.
Entity type:Organization
Organization Name:TIFFANY WHITE PARKER, DDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE-PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-353-0846
Mailing Address - Street 1:703 GREENVILLE BLVD SE STE 104
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5103
Mailing Address - Country:US
Mailing Address - Phone:252-353-0846
Mailing Address - Fax:
Practice Address - Street 1:703 GREENVILLE BLVD SE STE 104
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5103
Practice Address - Country:US
Practice Address - Phone:252-353-0846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty